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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr All APRLICAhE INFO MUST BE COMPL. - D FOR APPLICATION TO BE ACCEPTED Dater Permit Number: RECEIVED Building Permit Application 3 OCT .0 8 2018 Planning and Development Services SCANNED I Permitting Department Building and Code Regulation Division BY Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 SQ u , County Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Wilidentlal , i PERMIT APPLICATION FOR: r), C-i� I PR®POSE© f�NPROUE(VIENi" LiJCA IC*?N: n L_ Address: l ('i G� �A - l ✓�1 P1'fv-c e- f� Legal Description: i12071/ZJ PropertyTax ID #: T - �, - 1_/ +� Of 000 :�� Lot No. Site Plan Name: Block No. Project Name: I Setbacks Front Back: Right Side: Left Side: Mechanical Gas Tank Ga I _ Electric _ Plumbing _ SP Total Sq.II Ft of Construction: Cost of Construction: $ a L�06 'iping _ Shutters nklers Generator Sq. Ft. of First Floor: Utilities: —Sewer —Septic Windows/Doors Roof 7 'tch .V' - Building Height: O ER/LE--SSEE: •©NT � CaTOR: Name h ' �i�i'I-iC 5el Name: - Address": 07 �L/����/!fi- � r .�„' Company""' p Y• City: �b ��� )1%!��('� Stater Address: Zip Code: ;&q_"'i 4Fax: City: State: Phone No. W -? - 05-5 Zip Code: Fax: Phone No E-Mail: ``►DC��;, i�'�i i((D. Q Fill in fee simple Title Holder on next tx page ( if different' E-Mail from thl Owner listed above) State or County License If value of !construction is 2500 or more, a RECORDED Notice of Commencement is required. S pPI.oa Big=STRtUGi' oN LI:FN t_AW DESIGNER/ENGINEER: Not Applicable ORTGAGE COMPANY: _ Not Applicable INam Name: e: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: =;Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. ri- i rl/ensse Contractor Agent for Owner i Signature Contractor/License VSlgn1=46 as of Holder STATE OF FLORID , STATE OF FLORIDA COUNTY OFF COUNTY OF ' TheSgrgoing instr ent was acknowledged before me this day 20 1S by The forgoing. instrument was acknowledged before me this day 20_ by of of (Name of person acknowledging) (Name of person acknowledging ) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification, Type of Identification Produced LASHAHNA INGRAM Produced Notary Public • State of Florida ! Commission No. i• . •= My C� S ey Dec Z0, 201ti S88i0n Commission No., (Seal) ac' (iolr1M # FF 177249 Bonded through National Notary A� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.